Strategies for Pain Assessment in Adult Patients With Delirium: A Scoping Review

Fischer, T; Hosie, A; Luckett, T; Agar, M; Phillips, J

Strategies for Pain Assessment in Adult Patients With Delirium: A Scoping Review

Fischer, T

Hosie, A

Luckett, T

Agar, M

Phillips, J

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Publication Type:: Journal Article
Citation:: Journal of Pain and Symptom Management, 2019, 58 (3), pp. 487 - 502.e11
Issue Date:: 2019-09-01

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Field	Value	Language
dc.contributor.author	Fischer, T https://orcid.org/0000-0003-3779-4396	en_US
dc.contributor.author	Hosie, A https://orcid.org/0000-0003-1674-2124	en_US
dc.contributor.author	Luckett, T https://orcid.org/0000-0001-6121-5409	en_US
dc.contributor.author	Agar, M https://orcid.org/0000-0002-6756-6119	en_US
dc.contributor.author	Phillips, J https://orcid.org/0000-0002-3691-8230	en_US
dc.date.available	2019-05-31	en_US
dc.date.issued	2019-09-01	en_US
dc.identifier.citation	Journal of Pain and Symptom Management, 2019, 58 (3), pp. 487 - 502.e11	en_US
dc.identifier.issn	0885-3924	en_US
dc.identifier.uri	http://hdl.handle.net/10453/135712
dc.description.abstract	© 2019 American Academy of Hospice and Palliative Medicine Context: Pain and delirium are highly prevalent in the same patient groups. Disturbances in attention, awareness, and cognition are characteristics for delirium and can compromise pain assessment. Objectives: The aim of this review was to examine and map models and understandings of pain and delirium as well as pain assessment instruments and strategies for adult patients with delirium. Methods: A scoping review of all publications that reported on pain assessment in adult patients with delirium was conducted with no time and language constraints, searching Medline, CINAHL, Scopus, Embase, and PsycINFO and systematically assessing for inclusion. Standardized data extraction and a narrative synthesis followed. Results: A total of 90 publications were included in the final analysis. Despite being recommended for practice, no evidence for the use of self-report or behavioral pain assessment instruments in patients with delirium was identified, with the exception of limited evidence for the validity of the Critical Care Pain Observation Tool and Behavioral Pain Scale in delirious intensive care patients. Proxy ratings of pain and comprehensive pain assessment hierarchies were also recommended, but not supported by evidence. Current models and/or understandings of pain and delirium were not applied in most publications. Conclusion: The current literature is insufficient to guide clinical practice in pain assessment in patients with delirium. Future research will be needed to address the validity of existing pain assessment instruments, apply theoretical and conceptual understandings of pain and delirium, and build on prior studies to close evidence gaps.	en_US
dc.relation.ispartof	Journal of Pain and Symptom Management	en_US
dc.relation.isbasedon	10.1016/j.jpainsymman.2019.05.020	en_US
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject.classification	Anesthesiology	en_US
dc.title	Strategies for Pain Assessment in Adult Patients With Delirium: A Scoping Review	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	58	en_US
utslib.for	1199 Other Medical and Health Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access	*
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	58	en_US

Abstract:

© 2019 American Academy of Hospice and Palliative Medicine Context: Pain and delirium are highly prevalent in the same patient groups. Disturbances in attention, awareness, and cognition are characteristics for delirium and can compromise pain assessment. Objectives: The aim of this review was to examine and map models and understandings of pain and delirium as well as pain assessment instruments and strategies for adult patients with delirium. Methods: A scoping review of all publications that reported on pain assessment in adult patients with delirium was conducted with no time and language constraints, searching Medline, CINAHL, Scopus, Embase, and PsycINFO and systematically assessing for inclusion. Standardized data extraction and a narrative synthesis followed. Results: A total of 90 publications were included in the final analysis. Despite being recommended for practice, no evidence for the use of self-report or behavioral pain assessment instruments in patients with delirium was identified, with the exception of limited evidence for the validity of the Critical Care Pain Observation Tool and Behavioral Pain Scale in delirious intensive care patients. Proxy ratings of pain and comprehensive pain assessment hierarchies were also recommended, but not supported by evidence. Current models and/or understandings of pain and delirium were not applied in most publications. Conclusion: The current literature is insufficient to guide clinical practice in pain assessment in patients with delirium. Future research will be needed to address the validity of existing pain assessment instruments, apply theoretical and conceptual understandings of pain and delirium, and build on prior studies to close evidence gaps.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/135712